Does anyone have a real plan for our healthcare system?

The future of the Affordable Care Act (ACA) is up in the air. Even when it wasn’t, it was never more than a bandaid over what many consider to be a chaotic and effectively nonfunctional healthcare system.

So it’s no surprise that most Democratic candidates — and President Donald Trump — are campaigning on promises to fix the system and lower costs for Americans.

The president’s critics have argued that his healthcare plan thus far has primarily been to criticize Democrats’ plan, blame immigrants and promise big changes with no details or timeline.

As the 2020 election draws closer, everyone is talking about healthcare again.

But does anyone actually have a comprehensive plan in place, or are they just repeating catchphrases they think sound good?

What is Trump’s health care plan?

If you recall the first two years of Donald Trump’s presidency, you may remember several big pushes by Republicans to repeal the ACA and replace it with a better plan.

However, when their plan ended up resembling Obamacare too closely, they essentially abandoned fixing healthcare and moved on to the next big topic.

So Trumpcare never materialized, even when Republicans held the House, the Senate and the White House all at once.

His critics have accused him of simply undoing what little has been done to fix the American healthcare system to undo former President Barack Obama’s legacy. This includes things like blocking the Medicaid expansion and other critical parts of the ACA.

His supporters argue that Trump has attempted to negotiate some deals that would improve the current system, such as getting better deals on drug pricing and allowing Americans to import drugs from Canada.

President Trump also wants to require medical providers to post their prices so people know how much they will pay beforehand. But that still requires sick individuals to look up costs and choose the cheapest hospital, rather than the closest hospital, in the case of a medical emergency.

However, the American public is still left with few details on how Trump will make it work and find a plan that will improve the current system.

Now let’s examine what the Democrats are proposing instead.

Medicare for All Explained

Thanks to Bernie Sanders’ 2016 presidential run and his popular “Medicare for All” mantra, all Democrats this cycle have had to present the same promise to remain in the race.

Along with Sanders who introduced the bill, Senators Elizabeth Warren, Kamala Harris and Cory Booker all co-sponsored the bill.

At a certain point in the election cycle, co-sponsoring the bill became a signal that someone planned on running. All the other Democratic candidates still in the race were not in a position to co-sponsor the bill because they either don’t currently hold office or are not in the U.S. Senate.

But today, plenty of those cosponsors have either reneged on their support for the proposal or have waffled heavily on the details, indicating that maybe they don’t support exactly what Sanders wrote. The devil, it turns out, is in the details.

So what does Bernie Sanders’s Medicare for All bill propose, and why are other candidates having trouble signing on now that the race is actually underway?

The answer depends on what you think Medicare for All should do.

How would Medicare for All work?

According to Sanders’s vision of healthcare for everyone, Medicare for All would get rid of the entire private insurance system as we know it today.

And while Sanders claims it would lower national healthcare costs, some financial analysts and economists predict that his proposal would in fact increase costs — significantly, by some measures.

For another, although the generic “Medicare for All” catchphrase polls very well, support for the proposal actually drops significantly when voters learn the details, namely longer wait times for some procedures.

Medicare for All would move the U.S. to a single-payer universal healthcare system in which all individuals automatically receive coverage through taxes on income and employers.

It would resemble Canada’s and the United Kingdom’s health care system.

The government would set standard rates for all procedures. As a result, people who need medical care wouldn’t have to call hospitals and ask how much they charge for a medical procedure while they’re in the throes of an emergency.

However, this would also lead to an increase in demand for doctors and medication. That means wait times will go up.

Although chances are they won’t make Grandpa sit in the waiting room patiently while his heart’s failing, Timmy with the severe migraines might have to wait a few weeks to see a primary care physician.

Other Medicare for All Proposals

Elizabeth Warren’s Medicare for All proposal is pretty similar to Sanders’s, but she recently clarified that mental healthcare would not be automatically included — which makes a pretty big difference for some on the left.

However, it may not be a major factor for those in the middle or to the right who are mostly opposed to the entire concept of “socialized healthcare.”

Other Democratic candidates like Pete Buttigieg have proposed a “Medicare for All Who Want It” plan, which essentially means creating a public option in which individuals can opt into Medicare.

Former vice president Joe Biden has proposed a similar idea. However, critics say the plan does not go far enough in cutting costs and providing universal coverage.

The future of the ACA is up in the air, but so are the proposals from the 2020 candidates.

Seeing as no one has any clear idea of what to do in the immediate future (aside from Bernie, who might have a heart attack before he can enroll us all in Medicare), it’s probably safest to assume nothing will improve in the immediate future.